Our Understanding is By Listening
What is 'Challenging Behavior'
The term “challenging behavior” has been used to refer to the “difficult” or “problem” behaviors
which may be shown by children or adults with a learning disability. Such behaviors
include aggression (e.g., hitting, kicking, biting), destruction (e.g., ripping
clothes, breaking windows, throwing objects), self-injury (e.g., head banging,
self-biting, skin picking), tantrums and many other behaviors (e.g. running
away, eating inedibleobjects, rocking or other stereotyped movements). Characteristically,
challenging behavior puts the safety of the person or others in some jeopardy
or has a significant impact on the person’s or other people’s quality
of life.
Challenging behavior, of course, is not
limited to people with learning disabilities but the term has
been particularly applied in this context. The severity of
challenging behavior can vary greatly. Very serious injury
(e.g. blindness, brain damage) can result from some sorts of
behavior (e.g. eye poking or head banging) and, in such cases,
urgent action is required to limit or reverse the effects.
In many cases, however, the term is used to refer to behavior
which does not have such immediately serious consequences but
is, nonetheless, very upsetting, disruptive or stressful.
In general, challenging behavior is rather more common in people with learning
disabilities than in people without disabilities though the pattern varies
considerably depending on the type of behavior being considered and the age
of the people. For example, significant self injury occurs in between 3% and
12% of children attending schools for those with severe learning disabilities
and is, therefore, much more common than in children without disabilities where
the rate is negligible. Conversely, seriously violent behavior (especially
involving the use of weapons) is rather less common amongst adults with learning
disabilities than other adults.
Why does it happen?
The first point to make is that there is no simple answer to this question.
It is helpful to remember, however, that most people without learning disabilities
display lots of challenging behavior very early in their lives. The “terrible
twos” usually don’t last but only because most 2-year olds
develop a range of communication and social skills which enable them to
get what they want and need rather more easily. Many children with learning disabilities do not develop such skills to anything like the same
extent and are left with much the same needs as their peers but much less competent
ways of getting them met.
INFORMATION SHEET
Basic Information about Challenging Behavior
In the past, and still currently to an extent, society has had rather unusual
ways of “disposing” of people with learning disabilities - such
as putting them in large groups in out of the way places. Such institutions
have often been characterized by severe social and material deprivation and
abuse, factors likely to worsen and in some cases create challenging behavior
Neither are families, schools or other settings immune to such practices, often
finding it difficult to respond constructively to the unclear needs of unusual
people. In general, then, many cases of challenging behavior appear to be
effective ways for a person with learning disability to control what is going
on around them. This may reflect their lack of more usual methods of control
and the more unusual nature of the environments to which they are exposed.
While the above is a generally accepted account of why challenging behavior
occurs we should always consider, especially if the behavior has just arisen
or worsened, the possibility that it reflects some kind of biological or emotional
disturbance. Children may bang their heads because their ear aches or hit out
because they slept poorly the previous night. Understanding the variation in
a person’s challenging behavior is often a key to promoting positive
change.
What can be done?
Unfortunately, challenging behavior is not generally like an infection which
can be treated by a Short-term course of antibiotics. In many cases there
will be no “magic bullets”, change may take some time (especially
where the behavior is well established), will almost certainly require changes
in the way other people behave and may be very susceptible to relapse.
Having said all this there is a great deal that can be done to prevent
and treat challenging behavior
The goal of prevention is a worthwhile but elusive one. Where challenging behavior
arises from a medical condition, a sensory impairment or similar, the more
such conditions can be remedied the better. On an everyday basis carers, parents
and teachers can try to ensure that the person has what they need when they
need it - help, attention, food, drink, preferred activities and so on. It
is very important, however, that people are also given the opportunities and
the skills to get things for themselves or to ask for them rather than their
always being available “on a plate”. Without the opportunities
of exerting such control people with learning disabilities will be in much
poorer positions when they get in to situations (as they inevitably will) where
they are expected to fend for themselves and speak up for themselves rather
more. One of' the keys to prevention (and also to treatment) is therefore to
emphasis the development of communication and independence.
If prevention has failed, early intervention is the next best thing. Parents
often complain that their
attempts to get help early on are met with bland reassurance (“he'll
grow out of it”) rather than practical assistance. Of course children
do sometimes “grow out of'” challenging behavior but the histories
of adults with serious challenging behavior suggest that their behavior generally
started at a young age and simply got worse. Parents should, therefore, take
their child's challenging behavior seriously especially if it is of a kind
not usually found in a child without a learning disability. What can parents
do? Getting help is obviously important but where that is not available or
slow to arrive parents should consider the following actions: treat the behavior
as evidence of a previously undetected problem. Is the child in pain? O bored?
Or being asked to do things they find difficult? Or trying to “tell” you
something? And so on.
• try to check things out for yourself. If you change something does that
stop the behavior? Can you teach the child to tell you what they want without
challenging behavior?
• keep some sort of record of when
the behavior happens and the things you have done to try to
figure out what’s going on. In a year or two’s
time you’All find that it’s very difficult to remember
the details
• if (and only if) it is safe to do
so then “ ignore” the behavior (don’t comment
on it, don’t tell the child off, appear not to notice
it) and change the situation (distract, divert) as quickly
as you can. If distraction or diversion is impossible you may
have to leave the child on their own
but you need to be sure that the situation is safe and be able to cope with
the behavior possibly continuing for some time before it stops
• if it is not safe to ignore the behavior
respond as calmly and blandly as possible to prevent the child
hurting themselves or others
• if you do have to respond, better
to respond quickly than slowly - otherwise you are teaching
the child to be more persistent
• challenging behavior can be an emotional
experience for parents - you may feel very angry with the child
or very depressed about their behavior Don’t be ashamed
of this, don’t bottle it up and don’t kick the
cat! Instead, talk about it with anyone who will listen and
understand. Faced with an individual child or adult who is
already showing serious challenging behavior, the psychologist
or other practitioner is likely to want to know as much as
possible about the circumstances in which the behavior occurs.
They may try to conduct a “functional analysis” of
the behaviors which sheds light on the particular needs which
this person gets met through their behavior They may then
be able to suggest ways of preventing the behavior or ways
of responding to it which, over time, reduce its frequency.
If they suggest the latter, however, they are also highly likely
to want to look at how the person can be taught alternative,
more acceptable ways of getting their needs met. Consistent
approaches of this kind carried out in a coordinated fashion
(e.g., both at home and school), coupled with strategies to
prevent injury or reduce the negative impact of the most serious
challenging behaviors, can be very effective, but the investment
of time and effort required should not be underestimated.
Source Tizzard Centre
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